Doshas, sorcery, spirits and the ICD: the pragmatics of nosologies and etiologies in an Ayurvedic mental hospital in Kerala, south India
(University of Leipzig)
Paper short abstract:
I will analyze the pragmatics and politics of how doctors and patients of Ayurvedic psychiatry engage different nosologies and etiologies. Ayurvedic psychiatrists' diagnostic and therapeutic practices and their politics of recognition are characterized by etiological and nosological pragmatism.
Paper long abstract:
The globally circulating nosologies of biopsychiatry are worldwide used for diagnosing mental illness and behavioral disorders. Moreover, practitioners of local medical traditions and vernacular healing engage the ICD and integrate the diagnostic entitities into their own frameworks. Beyond constating an antagonism of biopsychiatric and vernacular nosologies, anthropologists should therefore, I argue, ask how and why these categories are being made appropriate and how they are appropriated and transformed by various stakeholders. The discipline and practice of Ayurvedic psychiatry is an interesting case in point. Using the case of a governmental Ayurveda mental hospital in Kerala and drawing from interviews with doctors and narratives of patients and their family members there, I will analyze the pragmatics and politics of engaging different nosologies and etiologies. On the one hand, Ayurvedic "manasika doctors" (psychiatrists) strategically accentuate Ayurvedic physiology to respond to biomedicine and discard all supernatural influences that have long been part of "externally caused" mental affliction. On the other hand, doctors pragmatically utilize vernacular etiologies of sorcery and spirit affliction in order to gain patients' compliance for the purifying treatments while at the same time demarcating from these etiologies. The biopsychiatric, Ayurvedic and vernacular nosologies and etiologies as well as the treatments are in many ways linked and strategically accentuated and interpreted according to context. Thus, I argue, it is nosological and etiological pragmatism rather than doctrinal or theoretical purity that characterizes Ayurvedic psychiatrists' diagnostic and therapeutic practices as well as their politics of recognition.
Collaboration between psychiatry and anthropology: nosological and etiological challenges